Briefing-debriefing: Using a reflexive organizational learning model from the military to enhance the performance of surgical teams

We adopt an action-research approach to examine the applicability of briefing-debriefing sessions-a team-based, reflexive learning model being used in the Israel Air Force-to the surgical departments of a major, civilian tertiary center in Israel, and explore the potential impact of such a model on the incidence of preventable adverse events in these departments. Taking into account the similarities and differences between the two team contexts (i.e., surgical team and flight crew), we examine potential barriers to the implementation of such a briefing-debriefing technology in the surgical world, discuss the ways in which such barriers have been largely overcome in the particular case examined, and present the model currently being implemented by the surgical departments in our study. Additionally, based on a grounded theory approach, we generate propositions regarding the way in which briefing-debriefing frameworks might enhance the quality-related outcomes of hospital surgical teams. We pay particular attention to those aspects of the team-based learning model-such as a focus on status-free transparency and systems-based analysis-intended to promote double-as opposed to simply single-loop learning. (c) 2007 Wiley Periodicals, Inc.